When someone is ill, or hurting, or injured, they go to the doctor. They’re not too ill to get up, they don’t need the hospital or an ambulance. They can still carry on the basic daily functions – but they just don’t feel very well.

Maybe they have a temperature – a runny nose, a cough. Maybe they’re feverish. Or perhaps they were injured somehow – a cut, a graze, a sprain. At worst, broken bone. They might need a bandage, a cast. They might even just need a plaster.

Perhaps they need medication to fix it. It might be antibiotics, or pain relief while their body heals itself. They’re given a clear timeline – two weeks, a month, a couple of months, and you’ll be better. If you’re not, please come back.

So they come home from the doctor to their loved ones and they say “This is what happened, this is what’s the matter. I’ll be better soon.” They might have a day or more off work, or just need to sleep for a bit. Maybe (if they’re very lucky!) they get a card, or flowers, or chocolate.

No-one sends flowers for anxiety. You don’t get half a dozen roses because you’ve been too anxious to leave the house, too nervous to pick up the phone, too sick to get out of bed and see people. You probably won’t get chocolates for Depression – even if you’re hurting, physically hurting, from how low and dark and down every single day feels. They don’t do a selection box for that. There’s no sympathy card for OCD, no-one says “Sorry your intrusive thoughts are deafening at the moment, sorry you can’t sleep because your compulsions have taken over, sorry you feel like everything is your fault.”

No-one sends flowers for anxiety.

When you’ve had a baby, it’s very much the same. Yes you’ll get a card, for the baby. Flowers, for being a new parent. Chocolates, for comfort. You’ll have physical discomfort, maybe even physical signs – a C-section makes it hard to lift things or walk far, an episiotomy makes sitting down painful, maybe you get mastitis, or need antibiotics or blood thinners for a while. That’s OK. The hospital sends you home with follow up appointments for your scars and bruises.

People will ask about the birth. Was it ‘normal‘. Was it ‘easy‘. Was it ‘OK‘.

What if you say no? What if you said “No. It was traumatic.” Well they’ll ask “Oh no, was it long? Did you tear? Was it an emergency?”. But that’s not what you’re telling them. It doesn’t matter if it was long, painful, if you’re physically changed. It could have been the most textbook birth in the world. What matters is that it was traumatic. But maybe that’s not what they’re asking.

Perhaps you’re pregnant. You’ll have endless tests, blood tests and urine tests. They’ll take your blood pressure, offer Dopplers and ultrasounds. You’ll see your midwife, regularly, to make sure you’re physically well. They’ll jump on the first sign of illness – glucose, proteins, high blood pressure. Will they ask how you’re sleeping? What if you can’t sleep? Not through discomfort, or a wriggly baby, or back pain – what if you’re lying away at night counting kicks, terrified something it going to go wrong, has already gone wrong. What if you’re bought a home heartbeat monitor and you can’t stop using it, terrified your baby is sick, or you’re sick, or you’re doing something wrong. What if you just feel numb, empty – you can’t cope with the change to your life, your body. You feel nothing at all, you’re not excited. Even though you’re never alone anymore (eating for two, sleeping for two, taking blood tests for two) – you’ve never felt lonelier.

Mental illness is Invisible. People won’t ask. People won’t assume. Because people won’t see. Mental illness shares an awkward, grey area with other invisible illnesses – chronic pain, IBD, fibromyalgia. You could be in incredible pain, and no-one would know. No-one would ask.

So you need to talk. It sounds horrible – that it comes down to you, that it comes down to you fighting the very anxiety and depression that makes it so difficult to reach out – but it’s the first step you can take. Going to the doctor about your physical health? Bring a list of your worries, write down how you feel and if you can’t talk, show them the list. Seeing your health visitor? Tell her how you feel. Not how the baby is sleeping, talk about how you can’t sleep, won’t sleep, haven’t slept. Midwifes want to know how you’re coping, what you’re worried about, how they can help. Doctors want to talk about your depression.

Tell your loved ones. They might not send flowers, they might not have a card for you – but someone wants to know. It might be a partner, a best friend, a parent or sibling or relative. It might be a neighbour who you see every day, another Mum at a baby group, someone else you see regularly but never give an honest answer when they ask ‘How are you doing?’. Be honest. Talk. It might seem like your depression or anxiety is screaming at everyone ‘Look at me! I’m not OK!” but trust me – they can’t see it.

A brave face is not brave. Keeping quiet doesn’t help you get better. And maybe the doctor won’t be able to give you the plaster, the bandage, the physical and tangible sign that everything isn’t OK. But it’s a start. It’s the first step.

And if you can’t reach out, if you’re struggling to find someone who will listen and care and help (and trust me, there is someone in your life who will), why not speak to PANDAS? We can’t diagnose, we can’t fix everything, we can’t give you the plaster or the bandage. But we can listen. We can share our own experiences, we can listen to yours, we can reassure you that it does get better. We can be the person you reach out to if you’re feeling alone. Because we know – it’s OK not to be OK.

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